Page:Tropical Diseases.djvu/973

XLVIII] Skinner mentions 49 cases occurring in a regiment and battery of artillery: of these, 28 developed in Calcutta, 13 in Hong Kong, 4 in England, 2 in Allahabad, and 2 in Malta. Symptoms. The disease generally commences with fever of a remittent type in association with inflammatory swelling, usually of a subacute character, of the groin glands. The oblique inguinal glands are those most frequently affected, but at times it is the crural glands that are attacked. Sometimes both groins are affected, sometimes only one, sometimes one groin is attacked after the other. The affected glands slowly or more rapidly enlarge to the size of a hen's egg, or even larger. After several weeks, it may be months, the swelling gradually subsides. Occasionally the periglandular connective tissues inflame, the integuments become adherent, and suppuration ensues. If the suppurating glands be freely incised, or excised, the parts readily heal; but if they are left alone, or inefficiently treated, fistulous tracks form and may take a very long time to heal.

Hitherto no satisfactory explanation of this type of adenitis has been forthcoming. No special bacterium has been demonstrated in the tissues. There are no adequate reasons for supposing, as has been conjectured, that the disease has any connection with plague, or that- it is a form of pestis minor. Most probably the adenitis depends on some virus which has been introduced through an overlooked wound or insect bite on the legs or genitals. Treatment should consist in rest and soothing applications during the more acute stage. After pain and tenderness have subsided, graduated elastic pressure should be applied. Concurrent malaria would call for quinine ; syphilis, for mercury or the iodides.

On December 10th, 1882, Prof. A. MacAlister read a paper before the Royal Irish Academy on what were termed the horned men of Africa. In the British Medical Journal of December 10th, 1887,